Repealing the Affordable Care Act without a replacement plan is dangerous for the health and economic well-being of our Commonwealth. A new Harvard Medical School and New York University study shows that repealing the ACA would have tragic consequences for millions of Americans affected by mental illness and by the devastating opioid epidemic. 180,526 Pennsylvanians suffering from mental illness or substance use disorder will lose access to critical mental health services that the ACA makes possible. Pennsylvania ranks among the highest in the nation in opioid overdose-related deaths and prescribing rates. Nationwide, the study estimates that more than 4 million Americans with serious mental illness or substance use disorders, of whom about 222,000 have an opioid use disorder, would lose some or all of their insurance coverage. [continues 514 words]